HomeMy WebLinkAboutBLD2024-00289 - BLD CD Environmental Health Review - 4/5/2024 Permit No: 00 Le
MASON COUNTY R CEIVED
COMMUNITY DEVELOPMENT
P~Aaushifre EenRn Building,Planning MAR ' S 2U24
BUILDING PERMIT APPLICATION m
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NAME: 1 Q. NAME:�Y G/w�,.+ 6 .9.yC = �
MAI[.1N RESS: MAILING RPSS: R1 <
CITY: STA CFI'Y: STATE: H ZB': y Z
PHONE#1 1 ' 7/b'11'10 PHONE: CELL 9
PHONE IYL: EMAIL: -
EMAIL: L&I REG# R EXP. /�/' = Z
A ' OWNERO CONTRACTOR IBR n D
NAME EMML
MAILWG 2DREZ 21P2 CITY SPAT 2B r
PHONE _Do.7 CELL n 90 z,a
PARCEL INFORMATION:
PARCELI U ER(12 Digit N.1a,,) zOND+G •� ➢o
LWALD6SCRIP'F10N rAbma w) 4 Z-01AFtlZ?G735 FILE DISTRICT
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.l MI i•••,,eFc f�[ rl Fist w, ✓1 C
1S THE PRO2ECf WITHBV3m FT OF SIAPF{S)GREA'I'F.R THAN I9X V65(] NO� SNOW IAAD:_pf
MPROPERTYWrO MFTOFTBRF WWMG: ICAitdl /:
SALTWATERQ LAKEEI RIVERCREEK❑ PONDQ WEO.AND SEASONAL RUNOFF❑ STREAM❑
TYPE OR WORK: NEW ADDHION❑ ALTERATION]pp]�� REPAIR Q OTHER n
USEOPSTRUCTURE&awa.n,G-,,ac.wm'8M9Em)
LSUSE. PRIMARl'% SEASONAL NUMBFROFBEDROOMS NU➢1BEROFBATHROOMS3
HEATEDSTRUCFUREP YESlwitg,DI YE8 0
DESCRDIE WORK N
CO RAC�) AGE:�
ISTFLOORZ3-eu 1La4.R 2NDFLOOR_eN.R 3RDFLOOR a9.R BASEMENT aN.@
DECK I WVER®DECK, Q_N., STORAGE Pi ft. OTBER_p.R.
GARAGE�aq.R AuxArd DeMrMd❑ CARPORT Pi,& Auudua1DDftw0ad0
NR7FACTLMED HOME INFORMATION: •4 COPIES OFTHEFLOOR PLAN REQUIRED-
MAKE MODEL YEAR LENGTH
WIDTH BECROOME BATHS SERIALNUMBER
ENVH90NMENTAL HEALTH:
SHWAGE,SBWERSOUPI SEPTIC'K SEWF. [j / Nigil EXUi3WG❑
PLUMBWGWSTRUCTURh. YESA NO(I ffy ou lr compk dWm Adegavey Fosat
PERD4ETFNFOUNDATION DRAINS PROPOSED? Y It- 'tl EIUSTMGSO.Ff.
EKISTWG BEDROOMS PROPOSED BEDROOMS TOTALBIDROOMS
OWNER erhnaNeDias lnat wbmltYai oliremrtale aavnunm mry reeYlne Mp cNaf 4{vnilmwa4m./Nn menld wM Ne/
v9nalu2 belvx.l aetlare NNlem Ne wnw aM lLrtmmaxie�emallmmNleam reuhe M'm{mll eM bao MB wnRugcqua.IM1M
oNainea pfrmission hom all nw�r»aary peNea.ntluR�q mry ea[envwa btlAtta peNee al'uMmat�aWCmg mis pgect Tre w.nnttMPel
represenmNre.rePasmisawltlm Inlmnativ�Pm"+iaM is xwiela ma grata emplgeasaf Mum Cwirty pessm me above aeviEea PWeM1Y
mtl swaums)mrrcaMa aaa mspemm. mmspa vapgiunan bamn�as miiia.aia n..vii aaim.ntzaa wnmurxonkm�mmmewaa vani�lm
a.ys o,gmnswmm.b�x a anmamea rare Peaaa ar tm saga
nPROOFOFCONTINUCONTINU N OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
F 180 DAYS MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
CODE 14.08.42) 1OWie OWN (M�beN red EvtM OWHEIII I DekTALREVWW APPROVED DATE DENTED DATE TAGS/NOTESICONDITIONSPARTMENTEPARTMBNTALLTH Z
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